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rN CITY OF SUNNY ISLES BEACH CONTINUING PROFESSIONAL AR®iECTIRAL&EN6INEERIN6 SERVICES FIRMS ONLY(CM ® REQUEST FOR QUALIFICATIONS NO.12-04-02 ACORCP a CERTIFICATE OF LIABILITY INSURANCE �iTEMU DONYYi) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jerry Noyola Greyling Insurance Brokerage 7188:,F„,. (770)552-4225 I7elc Noe HMO 61 560-met 450 Northridge Parkway rg&ss.jerry.noyola€greyling.corn Suite 102 INSURERISI AFFORDING COVERAGE NAICI Atlanta GA 30350 rsuREa:Sentinel Insurance Company, LTD 11000 INSURED wsuRERNLontinental Casualty Company 20943 R.J. Behar & Company, Inc. INSURER C: 6861 S.N. 196th Avenue INSURER D: Suite 302 INSURER E: Pembroke Pines FL 33332 INSURER F: COVERAGES CERTIFICATE NUMBER:11-12 REVISION NUMBER: TI-0S IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AEA%SUER POLICY EFF POLICY EXP LOOTS 1115R WV) POLICY NUMBER IMMIDOlryN YY1 IMMDYYYY1 GENERAL LIABILITY FAGIMLRRENCE 5 1,000,000 GENTEJ X COM.IERCIAL GENERAL LIABILITY DnReliSFSS ICF. ,eve, 5 1,000,000 S A O,AIMMII AOE OCCUR 20SHMAC0037 11/17/201111/17/2012 MPOEm,/Any one Nemec) 5 10,000 PERSONAL A ADV INJURY 5 1,000,000 ® GENERAL AGGREGATE 5 2,000,000 Gen AGGREGGnr77=_uMJT APPUES--1PS, . ORcooncs couwop AGG s 2,000,000 —I PCUCY 1—X1 I 1 Sl Lac s AUTOMOBILE LIABILITY :COMBINEa E nNGLT L1'w' s 1,000,000 A ANY AUTO _ BODILY INLRY(Per peso,) S AIL W AXED SCHEDULED 20UECNG0289 11/17/201111/17/2012 BOOILY INJURY(Pe,acoBed) S _ •ATOS AUTOS XICRED AUTOS x eoLos EDP(Pei acoetw)ROPERTY DAMAGE S 5 X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 3,000,000 A ETCESSLIAB CLAIMSMADE AGGREGATE 5 3,000,000 DE IX I RETENTIONS 10,000 2058t4AC0037 11/17/2011 11/17/2012 5 WORKERS COMPENSATION I Tt,CRYSTi.XX74PI 1041- AND EMPLOYERS LABRUTY YIN ANY PRO0RIETORPARTNERJcSECUTNE piNIA EL EACH ACCIDENT S OFFICERAIEMBER EXCLUDED, (WMEwy in NH) EL DISEASE-EA EMPLOYEE 5 II yyeeaa'RIP;ID6e 'beN OF'tiFO IY4OPERATIONS below E DISEASE POLICY LIMIT 5 B Professional Liability AEU 28 936 36 39 11/17/201111/17/2012 oercian $2,000,000 A99re9ate $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101.AMIUwnI Remarks ScheduN.It more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Proposal Purposes ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOREED REPRESENTATIVE ® Joshua Howell/JERRY �- —� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. AD nrhts reserved. ®10 R.J.Behar SECTION 1 • PAGE 12